Trends and cross-country inequalities in the global burden of inguinal, femoral, and abdominal hernia from 1990 to 2021, with projections from 2022 to 2035: a cross-sectional study

BackgroundThe global burden of inguinal, femoral, and abdominal hernias remains significant, particularly in low- and middle-income countries, despite medical advancements. This study aims to examine trends and cross-country inequalities in the burden of these hernias from 1990 to 2021 and project future trends to 2035.MethodsUtilizing Global Burden of Diseases (GBD) 2021 data, we analyzed prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across 204 countries and territories. Development levels were quantified using the sociodemographic index (SDI). Analyses included descriptive statistics, joinpoint regression, Spearman correlation, frontier analysis, and a Bayesian age-period-cohort model for forecasting.ResultsFrom 1990 to 2021, global prevalence increased from 13.7 million to 16.4 million, while the age-standardized rate (ASR) decreased by 24.74%. Incident cases rose from 5.8 million to 7.2 million, with a 16% decline in ASR. Deaths increased from 42,118 to 48,012, but ASR fell by 45.16%. DALYs decreased from 2.6 million to 2.3 million, with a 42.31% drop in ASR. Projections to 2035 indicate continued growth in cases, with varying ASR trends. Inequality analyses revealed persistent disparities, disproportionately affecting populations with higher socioeconomic development.ConclusionsSignificant disparities persist in the global burden of hernias, with increasing cases despite declining ASRs. Continued growth and inequalities underscore the need for targeted interventions and policies.